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Bacterial growth and wound infection following saphenous vein harvesting in cardiac surgery: a randomized controlled trial of the impact of microbial sealant
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Cardiothoracic and Vascular Surgery, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden. (Preoperativ omvårdnad)ORCID iD: 0000-0001-7862-3652
Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Department of Laboratory Medicine, Clinical Microbiology ,Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-5939-2932
Örebro University Hospital. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. (Preoperativ omvårdnad)ORCID iD: 0000-0001-5403-4183
2014 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 33, no 11, p. 1981-1987Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to compare microbial skin sealant versus bare skin on the leg regarding intraoperative bacterial presence in the surgical wound and time to recolonization of the adjacent skin at the saphenous vein harvesting site. A second aim was to evaluate the incidence of leg wound infection 2 months after surgery. In this randomized controlled trial, 140 patients undergoing coronary artery bypass grafting (CABG) between May 2010 and October 2011 were enrolled. Bacterial samples were taken preoperatively and intraoperatively at multiple time points and locations. OF the patients, 125 (92.6 %) were followed up 2 months postoperatively regarding wound infection. Intraoperative bacterial growth did not differ between the bare skin (n = 68) and the microbial skin sealant group (n = 67) at any time point. At 2 months postoperatively, 7/61 patients (11.5 %) in the skin sealant versus 14/64 (21.9 %) in the bare skin group (p = 0.120) had been treated with antibiotics for a verified or suspected surgical site infection (SSI) at the harvest site. We found almost no intraoperative bacterial presence on the skin or in the subcutaneous tissue, irrespective of microbial skin sealant use. In contrast, we observed a relatively high incidence of late wound infection, indicating that wound contamination occurred postoperatively. Further research is necessary to determine whether the use of microbial skin sealant reduces the incidence of leg wound infection at the saphenous vein harvest site.

Place, publisher, year, edition, pages
Springer, 2014. Vol. 33, no 11, p. 1981-1987
Keywords [en]
intra-operative, skin sealant, saphenous vein graft harvesting, SSI, contamination
National Category
Infectious Medicine Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-32650DOI: 10.1007/s10096-014-2168-xISI: 000344071600014PubMedID: 24907853Scopus ID: 2-s2.0-84911005344OAI: oai:DiVA.org:oru-32650DiVA, id: diva2:676480
Note

Funding agencies are:

Research Comittee of Örebro County Council

Nyckelfonden at Örebro University Hospital

Available from: 2013-12-06 Created: 2013-12-06 Last updated: 2018-08-27Bibliographically approved
In thesis
1. The effect  of peroperative skin preparation on bacterial growth during cardiac surgery
Open this publication in new window or tab >>The effect  of peroperative skin preparation on bacterial growth during cardiac surgery
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Routine products are used and procedures are followed in order to prevent and minimize the bacterial contamination of the surgical wound, and thus reduce the risk of postoperative wound infections. The overall aim of this thesis was to investigate the effect of different preoperative skin preparation before cardiac surgery.

In study I, 10 healthy volunteers were compared in time to recolonization of the skin and bacterial growth with or without plastic adhesive drape. Bacterial samples were taken as paired samples on both side of the sternum. Plastic drape on disinfected skin seems to hasten recolonization compared with bare skin.

In study II, 135 cardiac surgery patients were comparing plastic adhesive drape versus bare skin on the chest regarding intra-operative bacterial growth. Plastic adhesive drape did not reduce the bacterial recolonization or wound contamination, P. acnes colonizes males more often than females and P. acnes is not affected by disinfection with 0.5% chlorhexidine in ethanol.

Study III, compared the leg harvesting site with or without microbal skin sealant in 135 CABG patients regarding intraoperative bacterial growth and postoperative wound infection. Almost no bacterial growth was found during surgery regardless of the use of microbial skin sealant and bare skin. A high incidence of postoperative wound infections (16.8%) in 2 month follow up was present and SSI was largely caused by S. aureus, i.e. other bacterial species than observed intraoperative.

Study IV, a descriptive study using phenotypic and genotypic methods investigate susceptibility to chlorhexidine among S. epidermidis indicating that S. epidermidis isolates following preoperative skin disinfection are sensitive tochlorhexidine.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. p. 99
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 50
Keywords
OR, plastic adhesive drape, microbial skin sealent, chlorhexidine
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-31039 (URN)978-91-7668-978-3 (ISBN)
Public defence
2013-12-16, Wilandersalen, Universitetssjukhuset i Örebro, S. Grev Rosengatan 18, 703 62 Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2013-09-30 Created: 2013-09-30 Last updated: 2017-09-15Bibliographically approved

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Falk-Brynhildsen, KarinSöderquist, BoNilsson, Ulrica

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Falk-Brynhildsen, KarinSöderquist, BoFriberg, ÖrjanNilsson, Ulrica
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European Journal of Clinical Microbiology and Infectious Diseases
Infectious MedicineMicrobiology in the medical area

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